Introduction to the Special Section: The American Psychiatric Association's Research Agenda for the DSM–V

Abstract

The articles provided within this special section of the Journal of Personality Disorders are abbreviated versions of papers presented at the first of ten international conferences that are intended to enrich the empirical base in preparation for the eventual development of the fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders. This article provides the historical background for and a brief description of the first conference, which was concerned with the research that would help move the field toward a dimensional classification of personality disorder. The question of whether personality disorders are discrete clinical conditions or arbitrary distinctions along dimensions of general personality functioning has been a longstanding issue (Kendell, 1975; Blashfield, 1984; Schneider, 1923). Proposals for a dimensional model of personality disorder have been made throughout the history of the APA’s and the World Health Organization’s (WHO) diagnostic manuals (e.g., Eysenck, 1970; Presly & Walton, 1973; Tyrer & Alexander, 1979). The third edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM–III; APA, 1980) was quite innovative in many respects (Frances, 1980; Millon, 1981) but it continued to diagnose personality disorders categorically despite the improvements in validity and clinical utility that would be obtained through a dimensional model of classification (Frances, 1982; Cloninger, 1987; Eysenck, 1987; Kiesler, 1986; Livesley, 1985; Walton, 1986; Widiger & Frances, 1985; Wiggins, 1982). The authors of the revised, third edition of the APA diagnostic manual attempted to address some of the problems inherent to the categorical model by using polythetic criterion sets in which multiple diagnostic criteria are provided, only a subset of which is necessary for the diagnosis (Widiger, Frances, Spitzer, & Williams, 1988). Compelling proposals for a more fundamental shift in how personality disorders are classified and diagnosed, however, continued to be made (e.g., Benjamin, 1993; Clark, 1992; Cloninger, Svrakic, & Przybeck, 1993; Costa & McCrae, 1990; Livesley, Jackson, & Schroeder, 1992; Oldham et al., 1992; Pincus & Wiggins, 1990; Siever & DaJournal of Personality Disorders, 19(2), 103-109, 2005 © 2005 The Guilford Press